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Thread: Rehab Delay

  1. #11
    If he is in someplace like Kindred, it is a nursing home, no matter what they call it. If it is licensed as a long term care facility instead of an acute care hospital, and surveyed and accredited by Joint Commission using long term care standards instead of acute hospital standards, it is a nursing home.

    (* atrify = atrophy)

    (KLD)

  2. #12
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    Quote Originally Posted by SCI-Nurse
    He should not be sitting at all if he has severe pressure ulcers. Try to find a physiatrist who will assess his contractures (not "constrictures").

    (KLD)
    Quote Originally Posted by ladybyrd043@hotmail.com
    I visit him quite often and talk to him on the phone every day encouraging him. And, a psychiatrist comes in to see him regularly.

    Just noticed this, and wanted to be sure you knew the difference. A physiatrist is a physician specializing in physical medicine and rehabilitation. (I didn;t know anything about this before I was hurt.) Since it was an important part of her advice. I figure your response about the psychiatrist may have just been coincidence, but just in case you didn;t see the different spelling .....

    Hope this all get sorted out soon. I ended up with a pressure sore early on in rehab. We just pushed through it, but I ended up with a sore that didn;t heal for 9 months. Healing it FIRST strikes me as a good idea.
    T7-8 since Feb 2005

  3. #13
    Thank you,
    I did notice the spelling difference, the psychiatrist comment was in answer to her statement about his state of mind due to delaying the rehab. However, I did not know what a physiatrist was so I appreciate the information.
    The Kindred Center is a part of St. Anthony's medical center, it is one floor dedicated to wound care only. It is in no way seen as a nursing home or meant to be a nursing home. It is in an acute care center and is not long term care.
    Because of lying down for so many months he at first has had some issues with being dizzy or nauseated when he sat up, but those seem to have resolved over the last week or so. He was able to sit up a week ago, in the wheelchair, for three hours without any problems (special evening--it was his 21st birthday). The PT therapists get him up twice a day, once in the wheelchair and once on the side of the bed, for as long as he can tolerate it...the side of the bed is the hardest for him and he can only manage it for about 20 minutes or so. His blood pressure doesn't seem to be a problem, at least not one that I'm aware of. Although, it was rather low when he was lying down yesterday while I was there. But, "and this concerns me somewhat" the nurse took his BP three times in order to get a "good one" and each time she took it she used his legs instead of his arms.
    Thanks,
    Debby, Troy's mom
    Debby, Troy's mom

  4. #14
    Sorry. It may be located in an acute care hospital but all Kindred Wound and Ventilator Centers (it is a chain) are licensed and accredited for subacute (ie, long term care=skilled nursing=nursing home), NOT acute care. Ask them.

    (KLD)

  5. #15

    Medicaid in St. Louis

    My son, Troy, will be going to rehab at the Rehab Institute of St. Louis this week. I have been talking to Karen Reeve about his stay there and because he is on medicaid he only gets 30 days at their facility.
    If he needs more rehab then they typically send patients to the Missouri Rehab Center in Mount Vernon, which is 211 miles away. My understanding is that good rehab is dependent (not exclusively)--BUT IS MUCH BETTER FOR THE PATIENT---if the family is involved in the process. Moving him that far away means that we won't be able to be involved at all. We won't be able to be there to learn what we need to in order to bring him home.
    So, is there a facility in or around St. Louis that accepts medicaid on a month by month approval that IS GOOD...another activity based rehab...that will give him what he needs and be close enough that we can be a part of his recovery?
    If anyone else has had an experience with dealing within the medicaid guidelines and made it work for them please let me know. I'm running out of ideas here.
    I have already contacted two state reps and a senator (I know them all personally) and they're looking into what can be done, but I'm hoping that whatever information I get from everyone--from personal experiences to their aid--that I can find a program that works for us and gives Troy what he so desperately needs....the best chance at recovery.
    Thank you,
    Debby, Troy's mom
    Debby, Troy's mom

  6. #16
    Hi Debby;

    I moved your thread here where families dealing with similar issues about Medicaid may choose to comment and advise you.

    John
    "Hope is like a road in the country; there was never a road, but when many people walk on it, the road comes into existence." Lin Yutang

  7. #17
    Senior Member Ashley's Avatar
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    I'm not sure how i can help you with the medicaid situation, but i did my rehab at the rehab institute in stl, and i had a great experience with their program. No matter how much time you have with them, they will try to do as much as they can in that time. I also suggest you and your family be as involved as possible in your son's recovery, it really helped me with mine. Let me know if I can help you with anything about the rehab institute.
    Courage, it would seem, is nothing less than the power to overcome danger, misfortune, fear, injustice, while continuing to affirm inwardly that life with all its sorrows is good; that everything is meaningful even if in a sense beyond our understanding; and that there is always tomorrow.
    -Dorothy Thompson

  8. #18

    Thank you

    He'll be going to the rehab institute early this week. Karen Reeve from there is going to see him tomorrow and he should go either Tuesday or Wednesday. I'm really glad he's going there...I researched the rehabs in the area to find the one that would meet his needs the best.
    I did not want a place that focused on teaching him to live within the disabilities...but to go beyond them as far as he could and that is why I want him to have more than 30 days of rehab. I know that in order for him to get as much as possible that he needs 60-90 days of rehab, but medicaid in this area doesn't allow facilities to do any more than the 30 days...they don't have it set up where they can do month by month approvals.
    That's why I need to know if there's a facility that he can go to after his time here that is closer than 211 miles away that will give him the rehab that he needs. He's only 21 and his recovery should not be limited by government bureaucracy--but on his ability to go beyond his disabilities and become a more productive part of society.
    Debby, Troy's mom
    Debby, Troy's mom

  9. #19
    Senior Member Ashley's Avatar
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    I totally agree, I'm sure you know to ask Karen about your options, maybe she can give you information on other facilities or maybe some sort of extended outpatient program at the least...I'm sorry I wish I could be more help!
    Courage, it would seem, is nothing less than the power to overcome danger, misfortune, fear, injustice, while continuing to affirm inwardly that life with all its sorrows is good; that everything is meaningful even if in a sense beyond our understanding; and that there is always tomorrow.
    -Dorothy Thompson

  10. #20
    Unfortunately, each state is free to set its limits for what amount of rehab they pay for (if at all) under their Medicaid program. It is most unusual to be able to get exceptions to this, although you can certain try to appeal. The Medicaid program is not a replacement for having private insurance, but a safety net for those who choose to be uninsured. It will never provide the same level of services you can get as either private pay or private insurance.

    A month is not bad...the average LOS for acute rehab nationally now (regardless of funding) is about 18 days for paraplegia and 34 days for tetraplegia. An outpatient program should then be continued, either a home after instruction on the inpatient unit, or through their own outpatient services ideally.

    It will be important for you both to maximize the benefit he can get for the days he will get paid for...attend every session, class, counseling session, etc., don't refuse anything. Get handouts, read them and ask questions. Start from the first day to plan for discharge so you will be prepared (get the home eval done early, and get bids for remodeling or construction done immediately). Get equipment (wheelchairs, commodes, etc.) ordered as soon as possible. Meet with his team the first week and agree on goals that must be met for a safe discharge and continuation in an outpatient program.

    (KLD)

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